A greater percentage of residents in most of the metro region have health insurance than the average population in Missouri, Illinois or even the nation, according to U.S. Census Bureau estimates released Monday.

In the suburban counties, the percentage of those insured last year ranged from 88 percent in St. Clair County to almost 92 percent in St. Charles County. The national average was 85 percent.

Lagging behind was the city of St. Louis, where about 82 percent of the population had health insurance last year.

The figures, contained in the American Community Survey collected in 2008, marked the first time the Census Bureau has gathered health insurance data from individual counties and municipalities with more than 65,000 residents. The information was released as the debate over health care and insurance reform continues to rage in Washington and nationwide.

While the St. Louis area appeared to be holding its own for the overall population, another set of census figures released earlier this month showed declining coverage among Missouri's adult work force ages 18-64. In particular, the data reflect a drop in employer-sponsored insurance.

"It is scary," said Amy Blouin, executive director of the Missouri Budget Project, a nonprofit group that studies the effect of policies on low-income people. "One of the things it tells us is that employers are dropping health care as an option. Health care insurance has become cost prohibitive for employers."

Within the 18-64 age group that makes up the majority of the work force, the percentage of those with employer-based insurance dropped to 63.8 percent last year in Missouri, down from 70.2 percent in 2001. Comparable figures for Illinois were not available.

Anthem Blue Cross and Blue Shield in Missouri could not be reached for comment; a spokeswoman at UnitedHealthcare suggested contacting the Kaiser Family Foundation.

According to a report this month by the Kaiser Family Foundation, some 2 million people across the nation lost their employer-sponsored insurance last year. The percentage of employers offering coverage dropped to 60 percent this year from 69 percent in 2000.

"The most common reason is that it's too expensive," said Karyn Schwartz, a Kaiser senior policy analyst. "We expect more employers may be dropping coverage or asking employees to pay more."

In 2009, the annual total cost for family coverage purchased through an employer was $13,375, more than double the cost in 2000.

When employers drop coverage, workers have to buy their own health insurance, which can be extremely expensive and difficult to obtain if they have a pre-existing medical condition. They will join the rising ranks of the unemployed who have lost their jobs — and their insurance — in the worsening economy.

While some consumer groups say that private health insurance is too expensive and that many people can't afford the premiums, insurance companies say plenty of options exist. They suggest consumers shop around on the Internet and through insurance agents and independent brokers at no fee. Most insurance firms now often lower cost short-term or temporary plans aimed at consumers between jobs and recent college graduates.

Sometimes consumers — particularly young adults coming off their parents' plan — choose not to pay for coverage even if they can afford it, insurers say.

Schwartz said she expects next year's census figures on health care insurance will be bleaker because the current figures were collected before the economy bottomed out in 2008.

"The data that just came out ... (don't) capture the full effect of the recession," she said.

An example of that effect is Tom and LaDonna Appelbaum of Creve Coeur. She is co-owner of Orthomotion, a small business in Town and Country that deals in durable medical equipment; he is a lawyer. She had been insured through her husband's law firm. But they both lost their insurance when he was laid off in January. The couple remain uninsured because they can't afford the premiums.

"I'm in the health care industry, and I know what things cost," she said. "We're just hoping that we'll have a public option that we can afford."